Surgical management of cervical disc herniation associated with ossification of the posterior longitudinal ligament.

Abstract

Objective To discuss the clinical features,surgical method and outcome of cervical discherniation associate with ossification of the posterior longitudinal ligament.Methods Twenty-six patients of cervical disc herniation associated with ossification of the posterior longitudinal ligament from June 2003 to June 2008 were retrospectively analyzed.There were 16 males,10 females,with a mean age of 45 years.One to three levels of cervical disc herniation associated with two or more levels of ossification of the posterior longitudinal ligament were revealed by X-ray film,CT and MRI.The preoperative mean visual analogue scale (VAS) and Japanese Orthopedic Association (JOA) score were 5.3 points (range,4-7 points) and 9.3 points (range,5-12 points) respectively.Thirteen patients were decompressed by only anterior discectomy,11 by corpectomy and 2 by discectomy followed with posterior laminectomy.Results All patients experienced a remarkable recovery from radiculopathy,numbness,weakness and gait disturbance.Follow-up of 18 months(range,12-36 months) showed the mean VAS and JOA score increased to 2.5(1-4) points and 14.2 (11-16)points.The mean improvement rate of JOA was 63.2%.Leakage of cerebrospinal fluid which occurred in 2 cases disappeared afteR proper treatments without other complications.Conclusion The clinical symptoms of ossification of the posterior longitudinal ligament may appear or aggravate because of cervical disc herniation.The outcome is favorable after identifying the primary compressing factor followed by resection of the herniated cervical disc. Key words: Cervical; vertebrae; Ossification of posterior longitudinal ligament; Intervertebral disk displacement; Decompression; surgical